Topic Contents

Measles (Rubeola)

Topic Overview

What is measles?

Measles is a very contagious
infection that causes a rash all over your body. It is also called rubeola or
red measles. It is very rare in the United States because most children get the
vaccine as part of their regular childhood shots.

What causes measles?

Measles is caused by a
virus. It is spread when an infected person coughs, sneezes, or shares food or
drinks. The measles virus can travel through the air. This means that you can
get measles if you are near someone who has the virus even if that person
doesn't cough or sneeze directly on you.

You can spread the virus
to others from 4 days before the rash starts until 4 days after the rash
appeared. The virus is most often spread when people first get sick, before
they know they have it.

What are the symptoms?

The first symptoms of
measles are like a bad cold—a high fever, a runny nose, sneezing, a sore
throat, and a hacking cough. The
lymph nodes in your neck may swell. You also may feel
very tired and have diarrhea and red, sore eyes. As these symptoms start to go
away, you will get red spots inside your mouth, followed by a
rash all over your body.

When adults get
measles, they usually feel worse than children who get it.

It
usually takes 8 to 12 days to get symptoms after you have been around someone
who has measles. This is called the incubation period.

How is measles diagnosed?

Your doctor will ask
you about your symptoms and examine you. If your doctor suspects that you have
measles, he or she will do a blood test that will tell if you have
measles.

If you think you have measles, call your doctor so he or
she can report the illness to the local health department.

How is it treated?

Measles usually gets better
on its own. Most people can treat their symptoms at home. For home treatment,
take medicines to lower your fever. Also, get plenty of rest and drink lots of
fluids. Stay away from other people as much as you can so that you don't spread
the disease.

Most people get better within 2 weeks.

Can measles be prevented?

The measles vaccine
protects against the virus. The vaccine is usually given during childhood with
the mumps and rubella (German measles) vaccines (MMR) or with the mumps,
rubella, and chickenpox (varicella) vaccines (MMRV).

Some parents
are afraid to give their child the MMR vaccine because they have heard that it
can cause
autism. But researchers have done many large studies
and have found no connection between the MMR vaccine and autism.1

Getting your child vaccinated is important, because measles can sometimes
cause serious problems such as
pneumonia. And in rare cases, it can even cause
seizures or
meningitis.

If you have been exposed to
measles and you have not had the vaccine, you may be able to prevent the
infection by getting a shot of
immune globulin (IG) right away. Babies who are
younger than 12 months, pregnant women, and people who have
impaired immune systems that cannot fight infection
may need to get immune globulin if they are exposed to measles.

If
you have had measles, you can't get it again. Most people born before 1957 have
had measles.

Symptoms

Symptoms of
measles usually develop 8 to 12 days after a person
has been exposed to the virus. But the incubation period—the time between when
you are first exposed to the measles virus and when you develop symptoms—can
range from 7 to 18 days. Early symptoms of measles include fever [101°F (38°C) and higher], runny nose,
sneezing, sore throat, hacking cough, swollen glands, fatigue, diarrhea, and
loss of appetite. Many times, the eyes become red, irritated, swollen, and
sensitive to light. There may be a discharge from the eyes.

These
symptoms usually last 3 to 5 days. Toward the end of this phase, red spots with
tiny grayish white heads, called Koplik spots, appear on the inside of the
cheeks at the back of the mouth. These spots disappear within 18 hours, and a
blotchy rash follows. It starts on the face and behind the
ears and spreads downward over the entire body. A fever of
104°F (40°C) or higher often
occurs with the rash but drops in about 2 days.

The rash lasts
about 5 days and usually causes only slight itching, if any. The rash fades in
the same order it appeared. After the rash disappears, the skin may have a
brownish discoloration, which gradually fades away.

Some people
develop dangerous problems from measles, such as lung infection (pneumonia) or brain swelling (encephalitis).

A person who has measles
can spread the disease to others from 4 days before the rash breaks out to 4
days after the rash appeared.

Exams and Tests

Measles is most
often diagnosed by a history of exposure to the disease, the presence of the
characteristic
rash, a fever of
101°F (38°C) or higher for 3
days or more, and other symptoms, including eye
inflammation and chest congestion.

Blood
tests (immunofluorescent antibody assay and ELISA-type assay) confirm the
diagnosis and rule out other illnesses as causes of the symptoms. Swabs from
the nose or throat (viral culture) also may be tested for
the measles virus. Chest
X-rays may be done if your doctor suspects
pneumonia.

Treatment Overview

In cases without complications,
measles is treated with bed rest and care at home.
Home treatment includes drugs you can buy without a prescription that relieve
pain and reduce fever, such as ibuprofen and
similar drugs (for example, Advil, Motrin, Aleve) or
acetaminophen (for example, Tylenol). Do not give aspirin to anyone younger than 20 because of its link to a rare but serious illness
called
Reye syndrome.

Antibiotics are not used
to treat measles. But complications from the illness, such as
pneumonia or an
ear infection, may need antibiotic treatment.

Measles can cause a decrease in the level of vitamin A in the body, which
can lead to dry eye syndrome (xerophthalmia) and blindness. Low
levels of vitamin A in children raise the chance of death from measles
complications.2, 3 Vitamin A
supplements are recommended for:4

Children ages 6 months to 2 years who are
hospitalized because of measles or complications from
measles.

All children who are diagnosed with measles in
communities where vitamin A deficiency is a recognized problem, especially in
developing countries or in remote regions.

Prevention

The measles vaccine is effective in
preventing the disease. It is usually given in combination with the mumps and
rubella (German measles) vaccines (MMR) or the mumps, rubella, and chickenpox
(varicella) vaccines (MMRV). Because of widespread vaccination efforts, the
disease is extremely rare in the United States, although it could quickly
return if large numbers of people decide not to be vaccinated against it.
Studies have found that the risk of a reaction to the vaccine for
children who are allergic to eggs is extremely low.
For more information, see the topic Immunizations. If you were born after 1956
or received an early version of the measles vaccine, check your immunization
status before you
travel to countries where measles is still common.

If the measles vaccine is given to people who are susceptible
within 72 hours after they have been exposed to the measles virus, the vaccine
will probably provide them with some protection against the disease.4

Another preventive option for a person who has
been exposed to the measles virus is
immune globulin (IG). An IG injection can prevent or
shorten the measles illness. Babies younger than 1 year, pregnant women, and
people who have impaired immune systems may need to get an IG injection if they
are exposed to measles. Talk to your doctor if you or your child has been
exposed to this illness.

Home Treatment

Plenty of rest at home is usually the
best treatment for
measles. Stay away from other people as much as you
can so that you don't spread the disease.

If you have
measles:

Drink plenty of fluids. If you have a fever and
are not drinking enough liquids, you can become
dehydrated.

Take medicines you can buy
without a prescription that relieve pain and reduce fever, such as ibuprofen
and
similar drugs (for example, Advil, Motrin, Aleve) or
acetaminophen (for example, Tylenol). Do not give aspirin to anyone younger than 20 because of its link to a rare but serious illness
called
Reye syndrome.

Rest your eyes often. If your eyes are sensitive, close the
window blinds in your room and limit the amount of time you watch
television.

Avoid
contact with people who have never had measles and who have not been immunized.
You can spread measles to others from 4 days before the rash breaks out to 4
days after the rash appeared.

If your child has measles, keep him or her out of school
until at least 4 days after the rash appeared. Keep your child out longer if he
or she is not feeling well.

Call your doctor if your child:

Becomes confused or is difficult to wake
up.

Has a fever for more than 10 days. If your child still has a
fever after the third or fourth day of the rash, he or she may need to be
evaluated for signs of complications, such as
ear infection,
strep throat, or
pneumonia.

Has diarrhea that lasts longer
than 2 weeks or has any signs of
dehydration.

Has severe headaches or a
stiff and sore neck.

Seems to feel better, but the symptoms return
later.

If you or your child has measles and has not seen a doctor,
call your local health department. The health department needs to record all
cases of this illness.

Other Places To Get Help

Organizations

American Academy of Pediatrics

141 Northwest Point Boulevard

Elk Grove Village, IL 60007-1098

Phone:

(847) 434-4000

Fax:

(847) 434-8000

Web Address:

www.aap.org

The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.

Centers for Disease Control and Prevention (CDC):
National Center for Immunization and Respiratory Diseases

1600 Clifton Road

Atlanta, GA 30333

Phone:

1-800-CDC-INFO (1-800-232-4636)

TDD:

1-888-232-6348

E-mail:

cdcinfo@cdc.gov

Web Address:

www.cdc.gov/vaccines

The CDC's National Center for Immunization and
Respiratory Diseases has information about vaccines and the diseases that can
be prevented by immunization. The Web site includes the recommended
immunization schedules for children, teens, and adults. There is also
information about vaccine side effects and safety, school and state
requirements, and immunization records. Interactive schedules are also
available.

KidsHealth for Parents, Children, and
Teens

10140 Centurion Parkway North

Jacksonville, FL 32256

Phone:

(904) 697-4100

Fax:

(904) 697-4125

Web Address:

www.kidshealth.org

This Web site is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This Web site
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly e-mails about your area of interest.

National Network for Immunization
Information

301 University Boulevard

Galveston, TX 77555-0351

Phone:

(409) 772-0199

Fax:

(409) 747-4995

E-mail:

nnii@i4ph.org

Web Address:

www.immunizationinfo.org

The National Network for Immunization Information provides
information on immunizations, including each of the recommended childhood
vaccines, the recommended childhood immunization schedule, tips on using the
World Wide Web as a source of immunization and health information, and links to
other helpful sites. You can also search for the vaccines that each state
requires before entry into school or day care.

World Health Organization

Avenue Appia 20

1211 Geneva 27, Switzerland

E-mail:

info@who.int

Web Address:

www.who.int/en

The World Health Organization (WHO) is an agency of the
United Nations. It has about 200 member states. WHO promotes technical
cooperation among nations on health issues, carries out programs to control and
eliminate disease, and strives to improve the quality of human life.

The Web site has information on many health topics, including health and
disease related to travel.

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